Time trends in incidence of peptic ulcer bleeding and associated risk factors in Norway 1985–2008

OBJECTIVE: The aim of this study was to examine time trends in the incidence of peptic ulcer bleeding and risk factors in a defined geographical area in Norway. MATERIAL AND METHODS: Retrospective data were collected for 306 patients with bleeding peptic ulcers admitted to one hospital during the 1985–1986, 1995–1996, and 2007–2008 periods. RESULTS: The incidence in 1985–1986 was 52/100,000 and in 2007–2008 was 45/100,000. In the group aged 20–75 years, the incidence decreased by 54% from 54/100000 in 1985–1986 to 25/100000 in 2007–2008 (P = 0.001) and increased by 49% in the group aged >75 years from 272/100000 to 406/100000 (P = 0.0001). The use of aspirin or nonsteroidal anti-inflammatory steroid drugs (NSAIDs) was 31% in 1985–1986 and increased to 67% in 2007–2008 (P = 0.004). In patients using aspirin or NSAIDs, Helicobacter pylori was present in 73% in 1995–1996 and in 51% in 2007–2008. H. pylori infection declined from 84% to 52% between 1995–1996 and 2007–2008. CONCLUSIONS: The incidence rate of peptic ulcer bleeding did not change between 1985–1986 and 2007–2008, but decreased in the age group ≤75 years and increased in the age group >75 years. The use of low-dose aspirin and NSAIDs increased substantially over time, and H. pylori infection was still present in 51% of these patients in 2007–2008.